TENNESSEE BUREAU OF WORKERS' COMPENSATION 

IN THE COURT OF WORKERS' COMPENSATION CLAIMS 

AT MURFREESBORO 

MARGARET KING, 

Employee, 

) 

) Docket No. 2 01 ~ fi__J0005 

v. 

VANDERBILT UNIVERSITY 

MEDICAL CENTER, 

Self-insured Employer. 

) 

) State File No. 7'65-2116 

) 

) Judge Robert Durham 

) 

) 

COMPENSATION HEARING ORDER GRANTING SUMMARY JUDGMENT 

This matter came before the Court on July 11, 2019, upon Vanderbilt University 

Medical Center's (VUMC's) Motion for Summary Judgment. VUMC asserts as 

undisputed fact that Ms. King did not file a petition for benefit determination (PBD) until 

more than one year following its last voluntary payment for her claimed work injury. 

Thus, VUMC argues that the statute of limitations expired, which entitles it to summary 

judgment as a matter oflaw. For the reasons below, the Court finds VUMC is entitled to 

summary judgment. 

Procedural History 

In support of its motion, VUMC filed a Statement of Undisputed Material Facts 

regarding the statute of limitations. Ms. King did not respond. Therefore, the following 

facts contained within the Statement are deemed undisputed under Tennessee Rule of 

Civil Procedure 56.03: On January 17, 2018, Ms. King filed a PBD asserting that she 

suffered a work-related injury to her back on January 26, 2016. VUMC initially accepted 

the claim but made its last payment of benefits on November 18, 2016. 

At the hearing, Ms. King asserted that the mental stress caused by her financial 

losses due to the injury and her inability to find an attorney led to her delay in filing a 

PBD .. 

1 

FILED

Jul 23, 2019

03:17 PM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS
Legal Analysis 

Tennessee Code Annotated section 50-6-203(b )(2) provides that when benefits are 

initially paid, a claim shall be forever barred unless a PBD is filed within one year of the 

date of the last payment for compensation or treatment. VUMC is entitled to summary 

judgment on the issue of statute of limitations if the record before the Court establishes 

there are no genuine issues as to material facts, and VUMC is entitled to judgment as a 

matter of law. 

Here, the undisputed facts establish that Ms. King waited more than one year after 

VUMC's last payment for treatment before filing her PBD. While the Court is 

sympathetic to Ms. King's circumstances, they are insufficient to defend against 

VUMC' s motion. Having carefully reviewed and considered the evidence in the light 

most favorable to Ms. King, the Court finds VUMC has demonstrated that Ms. King's 

evidence is insufficient to establish a genuine issue of material fact as to the expiration of 

the limitations period. 

IT IS, THEREFORE, ORDERED that: 

1. VUMC's Motion for Summary Judgment is granted, and Ms. King's claim is 

dismissed with prejudice to its refiling. 

2. The filing fee of $150.00 is taxed to VUMC under Tennessee Compilation Rules 

and Regulations 0800-02-21-.07, for which execution may issue as necessary. 

3. VUMC shall file the SD-2 with the Court Clerk within ten days of the date of 

judgment. 

4. Absent an appeal, this order becomes final in thirty days. 

ENTERED JULY 23,2019. 

· o ert V. Durham, Judge 

Court of Workers' Compensation Claims 

2 
CERTIFICATE OF SERVICE 

I certify that a copy of the Order Granting Summary Judgment was sent as 

indicated on July 24, 2019. 

Name Certified Via 

Mail Fax 

Margaret King X 

Nathaniel 

Cherry 

Via Email Email Address 

X 10 Broadway Ave. Apt-C-1 04 

Cookeville, TN 38501 

Kingmargaret82@gmail.com 

X ncherry@howardtatelaw .com 

_& ~~' Penny ~ Clerk of Court 

Court of Workers' Compensation Claims 

WC.CourtCJerk@tn.gov 

3 
II 

I 

Compensation Hearing Order Right to Appeal: 

'I 

If you disagree with this Compensation Hearing Order, you may appeal to the Workers' 

Compensation Appeals Board or the Tennessee Supreme Court. To appeal to the Workers' 

Compensation Appeals Board, you must: 

1. Complete the enclosed form entitled: "Compensation Hearing Notice of Appeal," and file 

the form with the Clerk of the Court of Workers' Compensation Claims within thirty 

calendar days of the date the compensation hearing order was filed. When filing the 

Notice of Appeal, you must serve a copy upon the opposing party (or attorney, if 

represented). 

2. You must pay, via check, money order, or credit card, a $75.00 filing fee within ten 

calendar days after filing of the Notice of Appeal. Payments can be made in-person at 

any Bureau office or by U.S. mail, hand-delivery, or other delivery service. In the 

alternative, you may file an Affidavit of Indigency (form available on the Bureau's 

website or any Bureau office) seeking a waiver ofthe filing fee. You must file the fullycompleted Affidavit of Indigency within ten calendar days of filing the Notice of 

Appeal. Failure to timely pay the filing fee or file the Affidavit of lndigency will 

result in dismissal of your appeal. 

3~ You bear the responsibility of ensuring a complete record on appeal. You may request 

from the court clerk the audio recording of the hearing for a $25.00 fee. A licensed court 

reporter must prepare a transcript and file it with the court clerk within fifteen calendar 

days of the filing the Notice of Appeal. Alternatively, you may file a statement of the 

evidence prepared jointly by both parties within fifteen calendar days of the filing of the 

Notice of Appeal. The statement of the evidence must convey a complete and accurate 

account of the hearing. The Workers' Compensation Judge must approve the statement 

of the evidence before -the record is submitted to the Appeals Board. If the Appeals 

Board is called upon to review testimony or other proof concerning factual matters, the 

absence of a transcript or statement of the evidence can be a significant obstacle to 

meaningful appellate review. 

4. After the Workers' Compensation Judge approves the record and the court clerk transmits 

it to the Appeals Board, a docketing notice will be sent to the parties. The appealing 

party has fifteen calendar days after the date of that notice to submit a brief to the 

Appeals Board. See the Practices and Procedures of the Workers' Compensation 

Appeals Board. 

To appeal your case directly to the Tennessee Supreme Court, the Compensation Hearing 

Order must be final and you must comply with the Tennessee Rules of Appellate 

Procedure. If neither party timely files an appeal with the Appeals Board, the trial court's 

Order will become final by operation of law thirty calendar days after entry. See Tenn. 

Code Ann.§ 50-6-239(c)(7). 

For self-represented litigants: Help from an Ombudsman is available at 800-332-2667. 


II 

' 

Tennessee Bureau of Workers' Compensation 

220 French Landing Drive, 1-B 

Nashville, TN 37243-1002 

800-332-2667 

AFFIDAVIT OF INDIGENCY 

I, , having been duly sworn according to law, make oath that 

because of my poverty, I am unable to bear the costs of this appeal and request that the filing fee to appeal be 

waived. The following facts support my poverty. 

1. Full Name: ______ _____ _ 2. Address: - ------------

3. Telephone Number: - - ------- 4. Date of Birth:-----------

5. Names and Ages of All Dependents: 

----------------- Relationship:-------------

----------------- Relationship:-------------

----------------- Relationship:-------------

---------------- - Relationship:-------------

6. I am employed by: - - ---------------------------

My employer's address is:-------------------------

My employer's phone number is:-----------------------

7. My present monthly household income, after federal income and social security taxes are deducted, is: 

$ ______ _ 

8. I receive or expect to receive money from the following sources: 

AFDC $ per month beginning 

SSI $ per month beginning 

Retirement $ per month beginning 

Disability $ per month beginning 

Unemployment $ per month beginning 

Worker's Camp.$ per month beginning 

Other $ per month beginning 

LB-1108 (REV 11/15) RDA 11082 

I. 

I 
9. My expenses are: ! ~ 

' 

Rent/House Payment $ 

Groceries $ 

Electricity $ 

Water $ 

Gas $ 

Transportation $ 

Car $ 

per month 

per month 

per month 

per month 

per month 

per month 

per month 

Med icai/Dental $ 

Telephone $ 

School Supplies $ 

Clothing $ 

Child Care $ 

Child Support $ 

li 

I 

_ ____ per month 

_____ per month 

_ _ ___ per month 

_____ per month 

_____ per month 

_____ per month 

Other $ per month (describe: 

10. Assets: 

Automobile $ ____ _ 

Checking/Savings Acct. $ ____ _ 

House 

Other 

11. My debts are: 

Amount Owed 

$ ___ _ 

$ ____ _ 

To Whom 

(FMV) ----------

(FMV) ----------

Describe: __________ _ 

I hereby declare under the penalty of perjury that the foregoing answers are true, correct, and complete 

and that I am financially unable to pay the costs of this appeal. 

APPELLANT 

Sworn and subscribed before me, a notary public, this 

____ dayof _____________________ , 20 __ _ 

NOTARY PUBLIC 

My Commission Expires: _______ _ 

LB-1108 (REV 11/15) RDA 11082